Bonny,
I know nothing about the Latham device, but I just wanted to make a
comment.  We have a very good plastic surgeon, but he does not allow any of
the baby's with any cleft whether large or small to breastfeed.  In fact he
want Lamb's nipples to be used, not even a Haberman feeder (unless he has
changed very recently).  He doesn't want the baby to tire and to get
adequate nutrition to tolerate the surgery.
I gave him information on Breastfeeding the baby with a Cleft Lip and/or
Palate, but did not see any change.
Does anyone have good articles to send him that are written by MDs with
lots of good references?  Sorry I believe he will only listen to this kind
of work.

Helen RNC IBCLC
from PA where the drought has been declared an emergency



At 09:38 PM 7/16/99 -0400, you wrote:
>I apologize if this has been discussed before. I worked with a mom today who
>had just delivered a 6'13" term baby boy with a complete left side lip, hard
>palate, and soft palate cleft. Unfortunately the defect was a surprise, so
>there was a lot to do. We called the major hospital that we will be sending
>them to for the plastic surgery and were told that breastfeeding might be a
>problem with one of the interventions they have planned. Specifically, the
>thing is called a Latham device, used for gradually easing the cleft gums
>together. Models are made at 2 weeks and then the device is installed at 4
>weeks. It is best to not have any upward pressure on the thing so the
>feeling was that the tongue action of breastfeeding would do just
>that....push on the Latham device.
>
>Because of the dramatic extent of this little boy's cleft, it is extremely
>difficult to form a seal, in order to nurse with an SNS. The primip mom is
>12 hours post-Caesarian so she doesn't have a lot to pump yet. He started
>with a Haberman feeder tonight and will have his first appointment with the
>surgeon on Monday.
>
>The Latham is a metal plate with adjustment features that allow gradual
>tightening to bring the gum pieces together, meanwhile protecting the intact
>palate from collapsing
>
>Anybody have any comments about the Latham device? I don't want to mention
>the name of the hospital in this forum but suffice it to say we're talking a
>MAJOR hospital where they really do perform fantastic plastic surgery. It
>would be very difficult to say no to this caliber of cleft repair. I will be
>contacting the LC on staff there but in the mean time I would love to hear
>from anyone with experience with the Latham device.
>
>Thank you in advance.
>
>Bonny Nothern, IBCLC
>
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